Avoidance and elimination diets

An assessment should be made of the severity of the reaction, which gives an indication of the strictness of the recommended avoidance regimen. If the symptoms are severe and life threatening, complete elimination of the food is mandatory. Less severe symptoms may allow some degree of flexibility. A detailed explanation is essential for successful avoidance. Egg, milk, soy and nuts may be hidden in other foods and reading the ingredient list is essential. Alternative food should be suggested and it is essential to make sure that the avoidance diet is nutritionally adequate. A complete dietary history is of utmost importance and may uncover important sources of allergenic foods such as milk. It would also allow the caring physician/dietitian to suggest alternative foods with equivalent nutritional value. For example, soya milk or hypoallergenic formulae can be given for cow's milk intolerance during infancy. The services of a qualified dietitian are extremely useful.

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